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Artificial Organs

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https://www.readbyqxmd.com/read/28800676/development-and-evaluation-of-heartbeat-a-machine-perfusion-heart-preservation-system
#1
Yongnan Li, Qingdong Zeng, Gang Liu, Junzhe Du, Bingren Gao, Wei Wang, Zhe Zheng, Shengshou Hu, Bingyang Ji
Static cold storage is accompanied with a partial safe ischemic interval for donor hearts. In this current study, a machine perfusion system was built to provide a better preservation for the donor heart and assessment for myocardial function. Chinese mini-swine (weight 30-35 kg, n = 16) were randomly divided into HTK, Celsior, and Heartbeat groups. All donor hearts were respectively preserved for 8 hours under static cold storage or machine perfusion. The perfusion solution is aimed to maintain its homeostasis based on monitoring the Heartbeat group...
August 11, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28800389/silicon-micropore-based-parallel-plate-membrane-oxygenator
#2
Ajay Dharia, Emily Abada, Benjamin Feinberg, Torin Yeager, Willieford Moses, Jaehyun Park, Charles Blaha, Nathan Wright, Benjamin Padilla, Shuvo Roy
Extracorporeal membrane oxygenation (ECMO) is a life support system that circulates the blood through an oxygenating system to temporarily (days to months) support heart or lung function during cardiopulmonary failure until organ recovery or replacement. Currently, the need for high levels of systemic anticoagulation and the risk for bleeding are main drawbacks of ECMO that can be addressed with a redesigned ECMO system. Our lab has developed an approach using microelectromechanical systems (MEMS) fabrication techniques to create novel gas exchange membranes consisting of a rigid silicon micropore membrane (SμM) support structure bonded to a thin film of gas-permeable polydimethylsiloxane (PDMS)...
August 11, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28762511/efficacy-of-distal-perfusion-cannulae-in-preventing-limb-ischemia-during-extracorporeal-membrane-oxygenation-a-systematic-review-and-meta-analysis
#3
REVIEW
Yen-Yi Juo, Matthew Skancke, Yas Sanaiha, Aditya Mantha, Juan C Jimenez, Peyman Benharash
To date, no consensus exists regarding indication, technique, or efficacy of distal perfusion cannulae (DPC) in preventing limb ischemia among patients receiving venoarterial extracorporeal membrane oxygenation (VA-ECMO). We aim to examine the available literature and report association between DPC and risk of limb ischemia. PubMed/Medline, Scopus, Cochrane Central Register of Controlled Trials, Google Scholar, and bibliographies of included studies were searched from database inception until August 2016. Original studies describing the DPC placement technique and incidence of limb ischemia following DPC placement among VA-ECMO patients were included for systematic review...
August 1, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28762503/mechanomyography-based-wearable-monitor-of-quasi-isometric-muscle-fatigue-for-motor-neural-prostheses
#4
Eddy Krueger, Lana Popović-Maneski, Percy Nohama
A motor neural prosthesis based on surface functional electrical stimulation (sFES) can restore functional movement (e.g., standing, walking) in patients with a spinal cord injury (SCI). sFES generates muscle contractions in antigravity muscles and allows balance-assisted standing. This induced standing has several benefits, such as improved cardiovascular function, decreased incidence of urinary infections, reduced joint contractures, and muscle atrophy. The duration of sFES assisted standing is limited due to the quick onset of muscle fatigue...
August 1, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28744941/removal-of-cell-activating-substances-using-dialyzers-with-various-permeability-profiles
#5
Agnieszka Latosinska, Michael Hulko, Rose Speidel, Harald Mischak, Markus Storr, Bernd Krause
Despite multiple efforts to target an improvement in clinical outcomes of patients with end-stage renal disease, several challenges must still be addressed. Dialysis patients are at a high risk for complications, as reflected by increasing mortality rates. The objective of this study is to assess the impact of the application of dialyzers with varying permeability profiles on the removal of cell-activating substances from the blood of hemodialysis (HD) patients. Dialysate samples were collected using Revaclear 400 (RC) and MCO-Ci400 (MCO-CI)...
July 26, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28744907/design-and-hemocompatibility-analysis-of-a-double-suction-injection-suspension-blood-pump-using-computational-fluid-dynamics-methods
#6
Yue Wu, Liangfan Zhu, Yun Luo
The blood pump has become a possible solution to heart diseases. For the prevention of device failure and hemocompatibility problems, a rotary pump with suspended bearing is a preferred solution. In our previous work, a novel injection suspension method has been introduced to levitate the rotor. The suspension method is totally passive. This study aims to apply this suspension method to a double-suction pump, and the property of the pump was investigated using computational fluid dynamics (CFD) methods. The flow field of the pump is simulated based on the SST k-ω turbulent model...
July 26, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28744885/water-infused-surface-protection-as-an-active-mechanism-for-fibrin-sheath-prevention-in-central-venous-catheters
#7
David W Sutherland, Xin Zhang, Joseph L Charest
Protein adhesion in central venous catheters (CVCs) leads to fibrin sheath formation, the precursor to thrombotic and biofilm-related CVC failures. Advances in material properties and surface coatings do not completely prevent fibrin sheath formation and post-formation treatment options are limited and expensive. We propose water infused surface protection (WISP), an active method for prevention of fibrin sheath formation on CVCs, which creates a blood-free boundary layer on the inner surface of the CVC, limiting blood contact with the CVC lumen wall...
July 26, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28744884/shear-stress-induced-total-blood-trauma-in-multiple-species
#8
Chris H H Chan, Ina Laura Pieper, Christian R Robinson, Yasmin Friedmann, Venkateswarlu Kanamarlapudi, Catherine A Thornton
The common complications in heart failure patients with implanted ventricular assist devices (VADs) include hemolysis, thrombosis, and bleeding. These are linked to shear stress-induced trauma to erythrocytes, platelets, and von Willebrand factor (vWF). Novel device designs are being developed to reduce the blood trauma, which will need to undergo in vitro and in vivo preclinical testing in large animal models such as cattle, sheep, and pig. To fully understand the impact of device design and enable translation of preclinical results, it is important to identify any potential species-specific differences in the VAD-associated common complications...
July 26, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28741841/pulmonary-valve-opening-with-two-rotary-left-ventricular-assist-devices-for-biventricular-support
#9
Eric L Wu, Frank Nestler, Matthias Kleinheyer, Michael C Stevens, Jo P Pauls, John F Fraser, Shaun D Gregory
Right ventricular failure is a common complication associated with rotary left ventricular assist device (LVAD) support. Currently, there is no clinically approved long-term rotary right ventricular assist device (RVAD). Instead, clinicians have implanted a second rotary LVAD as RVAD in biventricular support. To prevent pulmonary hypertension, the RVAD must be operated by either reducing pump speed or banding the outflow graft. These modes differ in hydraulic performance, which may affect the pulmonary valve opening (PVO) and subsequently cause fusion, valvular insufficiency, and thrombus formation...
July 25, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28741665/remote-ischemic-preconditioning-and-clinical-outcomes-in-on-pump-coronary-artery-bypass-grafting-a-meta-analysis-of-14-randomized-controlled-trials
#10
Bin Yi, Jianhui Wang, Dingwu Yi, Yanling Zhu, Yumei Jiang, Yi Li, Shaoyan Mo, Yi Liu, Jian Rong
The purpose of this article is to perform the first pooled analysis on remote ischemic preconditioning (RIPC) used for the improvement of clinical outcomes of patients only undergoing on-pump coronary artery bypass grafting (CABG) in randomized controlled trials (RCTs). A systematic search was performed using PubMed, the Cochrane Library, and the Web of Science to identify studies that described the effect of RIPC on postoperative mortality in patients only undergoing on-pump CABG. The outcomes included postoperative mortality, postoperative morbidity (including incidence of myocardial infarction, atrial fibrillation, stroke, acute kidney injury, and renal replacement therapy), mechanical ventilation (MV), intensive care unit length of stay (ICU LOS), and hospital length of stay (HLOS)...
July 25, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28741664/in-vitro-evaluation-of-an-immediate-response-starling-like-controller-for-dual-rotary-blood-pumps
#11
Andrew F Stephens, Michael C Stevens, Shaun D Gregory, Matthias Kleinheyer, Robert F Salamonsen
Rotary ventricular assist devices (VADs) are used to provide mechanical circulatory support. However, their lack of preload sensitivity in constant speed control mode (CSC) may result in ventricular suction or venous congestion. This is particularly true of biventricular support, where the native flow-balancing Starling response of both ventricles is diminished. It is possible to model the Starling response of the ventricles using cardiac output and venous return curves. With this model, we can create a Starling-like physiological controller (SLC) for VADs which can automatically balance cardiac output in the presence of perturbations to the circulation...
July 25, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28741663/carbon-dioxide-flush-of-an-integrated-minimized-perfusion-circuit-prior-to-priming-prevents-spontaneous-air-release-into-the-arterial-line-during-clinical-use
#12
Marco C Stehouwer, Roel de Vroege, Gerard J F Hoohenkerk, Frederik N Hofman, Johannes C Kelder, Bas Buchner, Bastian A de Mol, Peter Bruins
Recently, an oxygenator with an integrated centrifugal blood pump (IP) was designed to minimize priming volume and to reduce blood foreign surface contact even further. The use of this oxygenator with or without integrated arterial filter was compared with a conventional oxygenator and nonintegrated centrifugal pump. To compare the air removal characteristics 60 patients undergoing coronary artery bypass grafting were alternately assigned into one of three groups to be perfused with a minimized extracorporeal circuit either with the conventional oxygenator, the oxygenator with IP, or the oxygenator with IP plus integrated arterial filter (IAF)...
July 25, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28722169/prognosis-based-shoulder-hemiarthroplasty-after-resection-of-proximal-humeral-malignancy
#13
Chao-Ming Chen, Po-Kuei Wu, Shang-Wen Tsai, Cheng-Fong Chen, Wei-Ming Chen
After wide excision of proximal humeral bony malignancy, prognosis-based reconstruction was performed at Taipei Veterans General Hospital. Bone prosthesis composite (BPC) was carried out among patients with a favored prognosis, while cement-spacer prosthesis composite (CSPC) was preserved for patients with poor prognosis. The aim of our study is to compare the clinical outcomes between the BPC and CSPC reconstruction procedures. From January 2000 to December 2014, we retrospectively reviewed the clinical outcomes of 34 patients who underwent shoulder hemiarthroplasty following wide excision of a malignant lesion of the proximal humerus, 15 of whom were treated with a BPC reconstruction and 19 cases were treated with a CSPC reconstruction...
July 19, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28722144/mechanisms-involved-in-hypersensitivity-reactions-to-polysulfone-hemodialysis-membranes
#14
Aranzazu Rodríguez-Sanz, Rafael Sánchez-Villanueva, Javier Domínguez-Ortega, Ana-María Fiandor, María-Paz Ruiz, Filomena Trocoli, Rafael Díaz-Tejeiro, Carlos Cadenillas, Elena González, Virginia Martínez, Margarita López-Trascasa, Santiago Quirce, Rafael Selgas, Teresa Bellón
Several cases of patients with anaphylactic or systemic hypersensitivity reactions to polysulfone (PS) hemodialysis (HD) membranes and tolerance to cellulose triacetate (CTA) membranes have recently been reported. To investigate the mechanisms involved in PS hypersensitivity, basophil, T cell, and complement activation were analyzed in acute-phase samples from two patients with systemic reactions to PS-based membranes. Basophil and T cell activation, as well as higher serum tryptase levels were detected in acute-phase samples compared with basal levels...
July 19, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28722142/lactic-dehydrogenase-in-the-in-vitro-evaluation-of-hemolytic-properties-of-ventricular-assist-device
#15
Donghai Li, Qingyu Wu, Shuhong Liu, Yuanyuan Chen, Haosheng Chen, Yingmao Ruan, Yu Zhang
Ventricular assist devices (VADs) can effectively improve the survival rate of patients with end-stage heart failure, but the hemolytic complications induced by long-time VAD support have received wide attention recently. The conventional evaluation method of the hemolytic properties of VADs by the indicator of plasma free hemoglobin (PFH) concentration is used but not sensitive enough to meet the needs of the actual examinations. In this study, an experimental method was applied for the evaluation of the injuries and damages caused by VADs to erythrocytes by both indicators of PFH and lactic dehydrogenase (LDH) in the in vitro hemolysis assay of VADs...
July 19, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28722138/a-red-blood-cell-model-to-estimate-the-hemolysis-fingerprint-of-cardiovascular-devices
#16
Riccardo Toninato, Giuseppe Fadda, Francesca Maria Susin
One of the most relevant and open issues within cardiovascular prosthetic hemodynamic performance is a realistic quantification of the damage sustained by red blood cells (RBCs). Specifically, the optimal design of bileaflet mechanical heart valves (BMHVs) requires both low shear stresses along the leaflets and short particle resident times. This study approaches RBC damage estimation by developing a numerical model of RBCs and computing the damage sustained by a set of passive RBCs immersed within in vitro flows...
July 19, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28718924/preliminary-study-of-a-novel-puborectalis-like-artificial-anal-sphincter
#17
Wentian Jin, Guozheng Yan, Hao Wu, Shan Lu, Zerun Zhou
Artificial anal sphincter (AAS) is an in situ implanted device that acts as a treatment for fecal incontinence regardless of etiology by augmenting the incompetent sphincteric structures. However, AAS is impeded from becoming a valid therapy by its high rate of ischemic complication and malfunction. This article presents an original puborectalis-like artificial anal sphincter (PAAS) that features a low risk of ischemia necrosis and rectal perception remodeling. The device retains continence by reproducing the action, including the pulling and angulating the rectum, of the puborectalis muscle, which forms the anorectal angle and reduces the required clamping pressure...
July 18, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28718889/veno-arterial-extracorporeal-membrane-oxygenation-support-in-patients-undergoing-aortic-surgery
#18
Zhaopeng Zhong, Chunjing Jiang, Feng Yang, Xing Hao, Jialin Xing, Hong Wang, Xiaotong Hou
Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is an option for mechanical support for patients with postcardiotomy cardiogenic shock (PCS). However, the use of VA-ECMO in patients suffering from aortic disease with PCS has not been greatly reported. This is a retrospective review of adult patients undergoing aortic surgery who received VA-ECMO support to treat refractory PCS from August 2009 to May 2016. A total of 36 patients who underwent aortic surgery with VA-ECMO support for refractory PCS were included...
July 18, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28718516/control-of-the-fluid-viscosity-in-a-mock-circulation
#19
Stefan Boës, Gregor Ochsner, Raffael Amacher, Anastasios Petrou, Mirko Meboldt, Marianne Schmid Daners
A mock circulation allows the in vitro investigation, development, and testing of ventricular assist devices. An aqueous-glycerol solution is commonly used to mimic the viscosity of blood. Due to evaporation and temperature changes, the viscosity of the solution drifts from its initial value and therefore, deviates substantially from the targeted viscosity of blood. Additionally, the solution needs to be exchanged to account for changing viscosities when mimicking different hematocrits. This article presents a method to control the viscosity in a mock circulation...
July 17, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28703280/the-oregonheart-total-artificial-heart-design-and-performance-on-a-mock-circulatory-loop
#20
Jeremy Glynn, Howard Song, Bryan Hull, Stanley Withers, Jill Gelow, James Mudd, Albert Starr, Richard Wampler
Widespread use of heart transplantation is limited by the scarcity of donor organs. Total artificial heart (TAH) development has been pursued to address this shortage, especially to treat patients who require biventricular support. We have developed a novel TAH that utilizes a continuously spinning rotor that shuttles between two positions to provide pulsatile, alternating blood flow to the systemic and pulmonary circulations without artificial valves. Flow rates and pressures generated by the TAH are controlled by adjusting rotor speed, cycle frequency, and the proportion of each cycle spent pumping to either circulation...
July 13, 2017: Artificial Organs
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